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08080047 CITY OF CU ERTINO I -R, BUILDING DiVIS16N 1"MAIT ;X-ONT—RACTO , NFQRMATTQN."�- 'WRIA"Wo$_. DU Nr A PERMIT NO. uD1 [ tM.`T'0RNING SPRING CT FAST WATER HEATER 08080047 OWNER'S NAME: PERMIT ISSUE DATE GILA, JAMES B 12601 J.32 AVE NE 08/06/2008 NE: SANITARY NO, CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO RMV/RPLC GAS WTR HTR ELECT PLUMB MECH 0, LICENSED CONTRACTOR'S DECLARATION Job Description I hereby itfilerm that I sam limervand maker Provision,of Caspar 9(Commencing Meet Seems 7M).1`01,iskm 3.f ft Btame.and Frolentatures Code,and my If...I. N fail force sure orebom Lice.Clam-[in.8 Dam.Contractor ARCHITECTS DECLARATION I understand my plans"I he teread as public nomms 9W� Licensed Professional 'Q OWNER-BUILDER DECLARATION i�31 . I botchy M.that I.mu,nept firecon ft Cmuesume.Lkcmc Law par flace a o following Mason.(Section 70315,Business and Prokasions;Code:Any city or county 2 which onsions a promote in consumer,sent.minion,demolinds,or ropair any tincture prior he its Invariant,seem requircs,the applicant rarsuch permit us file 4 signed RmmoCnL mmG We he I,licamad pursuant tame provisions of the Contneeta's Uncrom Law(Chapwg Sq. Area Valuation (cmarencracm,with Sectime 7M0)of Divisicut infuse Base.and Pralines..Codc)m Mae he is mouppe,therefrom and the buts for W alleged Corruption.Any violation of Section 7031.5 by a,applicant fears peornit objects W applicant to.CMI peroft,of APN Number Occupancy Type me a=We fin hundred dollars(M). 0 I."amser often,pmporty,army eamployeas with wage.Nee role emenimentati willdoNewrk.wdfttuucrumBnatinmnftdoroffmdfwsam(S=.7 .Badmass and ponfinsomma Cod.-The Crestractor's Lkamm Law clow an,apply an a.asomer of Required Inspections owncreployced.providend that each impartwortmenta sommat mandate croffered few ad&If. howerner.Me building or improwsrome Is mid within one,year,ofnempladma,becomer- builder mile hant ft burden of proving We M did Met bould or lonpown for purpose of sala.). 0 1,n Manor of ft property,am exclusively contracting with liccaustud comae trat an courstrace th,project(Sec.7044.Bustreca,and Proleadons Cade:)The Contractors Li- .Law does Cot apply on.owner of Property man builds or iropeontl ftenceet.and who contracts for such imjecre,with a contersector(s)Remained Paramount to W Commentor's Liam"mLaw'. 0 1.ro taternal under See. _.a et P C for this modern ow. Dam- WORKER'S COMPENSATION DECI-stRATION I thereby affirm under porosity of perjury are of W millowing dealsonflonce: I Nm and well maintain a Certificate of Cartoon,in sall-loseene for Woracer'.Camper. sation.a provided for by section 3700 of W Labor Come.far the performance of ft marle,for which this Pannell is bound. 0 1 ban and will mamusso Workers Compensation Imprource,as raque by Section 37W of the Lmor Code.far the offornumcc of W work for which this permit is leaned. My Wturlecors Compensation Incen.carrier and Policy toursk,wes: Cartier. Policy No.; CERTIFICATE OF EXEM PrION FROM WORKERS COMPENSATION INSURANCE IMissecorm mand me beecompleentl IfW form,Is forme hundred date=(SIM) or to=) I coury that in the pefternamme of the work her which does permit Is earned,I shall one employ any person in my momenemso u no became abject It the Worked Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT'.If.&Act making this Ccounceme of Emonaption,you shoum become subject m W Workers Crompcessudom provisions of W LA!xar Code you am Z forelewitin comply with each proviumnat or muPon fit shall be doomed renland. z 0 CONSTRUCTION LENDING AGENCY Thereby air.We ft.I,.cmounntim moding.gtopeCy for the ocommon.or Lit> me wore for which this permit Is inesul($ce.3097.Civ.C.) ELeroler's Nam. Z)z Landn" U a I careely that I Inave mood this application and sato that the&C*w information is ILI ccmmcl I epee in comply with all city and county onalmemmus and sum hon mining to C) building Construction,and paremy someone rappompostinui of this city to Consulate ft above-nomemmund property for Impaction,purposes. glw (Wc)agree to Men,immorally and lump homeless;ft City of Cupertino against S liabilities.Judgments,came and experstrous which may In any way accres,against seeld City U in commemorate of me granting of his permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by Date SOURCE REGULATIONS. - Re-roofs (�;7 Siganaurre ofAppticent/Comenicior Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will ft applicant or future bulldogk. or handle hamordoets meacrial as coll by the Cup Municipal Cock.Chapter 9.12.W ft Health and Safety Cooke.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. Oy. ONo Will ft applicant or future building accupeent use equipmemel or dellce,which If a roof is installed without first obtaining an inspection,I agree to remove it Wxdous air coatearemuns as defined by W Say Arem Air Quality Management all new materials for inspection. District? 0 Y. ON. I have mad fth..,dmwe,i.Ismqi...a.mkrChpw,6.95offtCalifor- niaHolm&SafoyCocW.Socfi=B5D5.25533aM25534.1uMMmmand Wifft builtifteg does me Currently turn a usessone ft,it 4 my Memorability W notify ft occement or ft requencescons which Most be MCI poor W issuance of,Ccenficam of Occupancy. Signature of Applicant Date Owner or authearend agent Dow All roof coverings to be Class or better CITY OF CUPERTINO . 4 STEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36652037 . 00 DATE ISSUED. . . . . . . : 08/06/2008 RECEIPT # . . . . . . . . . : BS000005707 REFERENCE ID # . . . : 08080047 SITE ADDRESS . . . . . : 11572 MORNING SPRING CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : GILL JAMES .B ADDRESS . . . . . . . . . . : 11572 MORNING SPRING CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5121 RECEIVED FROM . . . . : JEFF JORDAN CONTRACTOR . . . . . . . : JEFF JORDAN LIC # 29100 COMPANY . . . . . . . . . . : FAST WATER HEATER ADDRESS . . . . . . . . . . : 12601 132 AVE NE CITY/STATE/ZIP . . . : KIRKLAND, WA 98034 TELEPHONE . . . . . . . . : (800) 454-8955 •, FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --------— ----—------ ---------- ---------- ---------- ---------- --------- 1BSEISMICR VALUATION 449 . 00 0 . 50 .0 . 00 0 . 50 0. 00 1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1PRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 .48 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER -- --------------- -------------------- CREDIT CARD 213 . 12 VISA --------------- TOTAL RECEIPT 213 . 12 - VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- ---------------------------- -------- ---------------------------- 518 WATER HEATER • Permit No: D?)DO4r12407 v (office use only) City Of Cupertino Building Permit Application E-Mail: Building-Permits(cDcupertino.org (Address is case sensitive). Jobslte Address:11572 MORNING SPRING CT Date: 8/5108 Assessor's Parcel Number. `Jj(o(p 57,2 c):57, O U Owners Name: GILL, KAREL 8,JIM Phone No: (408)252.8845 Project Valuatlon: 449.00 Building Permit Info: Bldg_ Elect Plumb X Mach Job Description Remove/Replace Gas Water Heater Contractor Information Company Name: FAST WATER HEATER COMPANY Phone No: Contact Name: Carol Randall Fax No: 800454-8955 • Address: 12601132ND AVE NE E-mail:carolr@fastwaterheater.com City, State &zip code: KIRKLAND,WA 98034 State Contractor's Lic. No: 877489 Expiration Date: 5/31/10 Worker's Comp No: 1761660 Expiration Date: 12/1/08 Carrier: California State Fund City of Cupertino Business License No: 29100 Credit Card Information Credit Card No: Expiration Date: 11/10 Name on Card: Jeff Jordan Visa ® MasterCard ❑ American E ress ❑ The Building permit application and a completed &signed contractortsubcontractor form need to be submitted with each permit. Community Development 10300 Torre Avemte Cupertino CA 95014 Telephone(408)777-3228 OOF Fax(408)777-3333 �CUPEkTINO Building Department JOB ADDRESS: 11572 MORNING SPRING CT PERMrr# OWNER'S NAME: GILL, KAREL&JIM PHONE# 408)252-6845 GENERAL CONTRACTOR:FAST WATER�HEEAaTTEER COMPA PAX# 425.814-9516 m I anot using any subcontractors: ^ - !u � 8/5/08 Signature Date Please check applicable subcontractors and complete the followinginformation SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets&Millwork Cement Finishing Electrical Excavation Fencing Flooring:Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date • i